Siriraj Vaccination Pathway against Tetanus-Diptheria- Pertussis in Pregnancy

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Pattarawan Limsiri
Chenchit Chayachinda
Surasith Chaithongwongwatthana
Pareeda Tuanwaena


         Despite the fact that Tetanus-Diphtheria-Pertussis vaccine has been included in the national Extended Program of Immunization for over 40 years, the mortality rate remains remarkable, especially among children aged 0-4 years. Moreover, the incidence of pertussis, as well as its mortality, appears to be rising in recent years. As a solution, the recommendation by various academic bodies to vaccinate pregnant women with Tetanus-Diphtheria-Pertussis vaccine for each pregnancy during gestational age of 27-36 weeks has been launched. The maternal-generated immunity as an in-utero passage of antibody to the fetus which will last for the first six months of vulnerability window period has long evidently been promising. According to a systematic review, the effectiveness of preventing pertussis infection in infants was 69-91%, the prevention of infant’s admission was 91-94% and the prevention of infant deaths was 95%. Siriraj pathway for maternal immunization against Tetanus-Diphtheria-Pertussis has been proposed for the convenience of applicability to Thailand context. In the past, if a pregnant woman had not been boosted against tetanus for more than 10 years, three doses of tetanus vaccine would be needed. According to this review, only one dose booster with dT or Tdap is sufficient and the booster dose should be scheduled to give pregnant women a Tdap at recommended time when needed.


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Limsiri P, Chayachinda C, Chaithongwongwatthana S, Tuanwaena P. Siriraj Vaccination Pathway against Tetanus-Diptheria- Pertussis in Pregnancy. Siriraj Med Bull [Internet]. 2022 Jan. 1 [cited 2023 Dec. 3];15(1):38-47. Available from:
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